Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Hand |
225XH1200X | 67 | Occupational Therapist in Private Practice |
| NPI Number | 1699087346 |
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| LBN Legal business name | IDAHO HAND & UPPER EXTREMITY THERAPY | ||||
| Authorized official | ROBERT SWIDER - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 07/10/2010 | ||||
| Last updated | 01/24/2011 - About 15 years ago | ||||
| Identifiers |
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